Patient, physician, and policy factors underlying variation in use of telemedicine for radiation oncology cancer care

Abstract

Abstract Background Oncology telemedicine was implemented rapidly after COVID‐19. We examined multilevel correlates and outcomes of telemedicine use for patients undergoing radiotherapy (RT) for cancer. Methods Upon implementation of a telemedicine platform at a comprehensive cancer center, we analyzed 468 consecutive patient RT courses from March 16, 2020 to June 1, 2020. Patients were categorized as using telemedicine during ≥1 weekly oncologist visits versus in‐person oncologist management only. Temporal trends were evaluated with Cochran‐Armitage tests; chi‐squared test and multilevel multivariable logistic models identified correlates of use and outcomes. Results Overall, 33% used telemedicine versus 67% in‐person only oncologist management. Temporal trends (ptrend 0.05, all comparisons). Conclusion Though toxicities were similar with telemedicine oncology management, there remained lower uptake among non‐White patients. Continuing strategies for oncology telemedicine implementation should address multilevel patient, physician, and policy factors to optimize telemedicine's potential to surmount—and not exacerbate—barriers to quality cancer care.

Keywords

• COVID‐19 pandemic
• disparities
• policy
• radiotherapy
• telemedicine